On military remains in landfills

Blackfive and others recently wrote  about the “scandal” that some tissues  were disposed of as medical waste.  I commented there, but think that it’s worth putting up as an independent post:

I think this issue is a function of changing cultural norms, the evolution of a culture where being offended is a sacrament, and the fact that real life isn’t like it seems on TV.

Back a few decades ago when I was first in training, we *never* returned tissues to a body after autopsy, and we *always* disposed of the removed organs as waste, unless there was a specific reason to act differently. Why? First, we — and the families and the funeral homes and the religious leaders — didn’t see a piece of liver as sacred. Second, it was much more practical. The funeral homes didn’t have to deal with a bag of decomposing fragments of tissuethat couldn’t be perfused with embalming fluid, we didn’t have to spend resources to account for them individually, and the families could have their funerals faster and at less expense.

Instead, we treated them as if they were taken from a living person. Let’s say that you have appendicitis and have to have surgery to remove that appendi. What happens to that bit of tissue once it’s taken out? Well, it goes to a pathologist who looks at it and makes sure that nothing too weird is happeneing — that your appendix didn’t have problems because of an unexpected cancer or that there isn’t some sort of odd developmental or unusual inflammatory problem. Is it then returned to the patient for burial? Is it placed in a shrine somewhere so that people can come visit the appendix and say prayers? Not usually, though folk try to accomodate personal preferences for things. No, usually it is treated as medical waste. It’s put in a container, incinerated, and disposed of — often by being put in a landfill.

That’s what happens if the patient is alive. Some years ago, it’s also what happened when the patient was dead. After all, an appendix is an appendix. It’s not a person. But times have changed. Now, if the patient is dead there’s a magical transformation that turns that appendix into a talisman. Now, it must not be treated as if it were a piece of tissue, it must be treated as if it were a person in it’s own right, and accorded the honor an entire person would get.

I’m not saying that one way is “right” and the other is “wrong.” There is no “right” answer here — since it’s a function of current cultural norms, not of some sort of absolute. But the bottom line is that treating a piece of tissue like a piece of tissue in no way *inherently* implies a lack of respect for the dead, any more than disposing of that appendix in the living person inherently implies a lack of respect for the living.

But then the next issue comes up. The second issue is that we live in a world today where the taking of offense is a sacrament, regardless of whether or not offense is intended. So, it fundamentally doesn’t matter whether or not disrespect was intended. If it’s possible to accuse people of disrespect, then, by God, go for it. It’s your God-given right and duty to take offense at as much as you can and as often as you can, regardless of intent.

And this issue is perfect for it. Part of the grieving process is anger and looking for targets to focus that anger on. In my own profession, this is common when I determine the cause or manner of death to be something the family does not want to deal with — HIV (at least a few years ago), suicide, drugs, etc. I have spent the past 30 years being the focus of family anger. There are websites that name me as part of a vast conspiracy to cover up the homicide of a loved one. It’s not pleasant, but part of my professional training is learning how to absorb that anger without responding in kind, and understanding that being the focus of it is part of my service in the grieving process. If they focus their hatred on me, they won’t be as likely to focus it on the police, other family members, etc. It’s natural for families who are grieving to be angry — and to become angry at everything associated with the death, including those who deal with it from a professional capacity. But, unfortunately, people who are grieving can perceive disrespect where none is intended, and society today celebrates outrage and encourages it. In today’s society where everybody is either victim or oppressor, we love to see a victim and we love to hate the oppressor.

Finally, this isn’t like TV. Remember that we are often talking about small pieces of tissue no larger than a marble. We are talking about situations where tissue may be retrieved and processed for months. Again, back in the day, when we had an explosion or crash that left lots of little fragments, we would identify what we could — through anthropology, dentition, and more recently DNA — and then just divde up the rest so that families could have something to bury. In the Pentagon attack, the military spent millions of dollars attempting to identify every small piece of tissue using DNA methods. But, really, what was accomplished by spending all that money, that could have otherwise been spent for things like benefits for survivors, on making sure that a decomposing piece of tissue the size of a postage stamp was identified before being incinerated? I don’t know — but obviously that’s where we want to spend our resources. And, quite frankly, if you think that we weren’t respectful of the dead or that we were not outraged by what happened, then clearly you weren’t there. The military did a great job in the Pentagon attack.

And what happens over time in these cases? We don’t make these identifications in a day, nor do we do recoveries overnight. It can take weeks or months. Should we send the families a little baggie of rotting flesh every six weeks or so as the pieces are identified? Should we dig a new grave every week or two for a piece of skin that comes up? In the Pentagon attack, we tried to give the families the choice. In every case I’m aware of, once the funeral was held, the families wanted the tissue disposed of and not returned to them. And that was the right choice. I’m not sure anybody is served by bringing this up again. In fact, my personal opinion is that this is being used as a surrogate to attack the military for other reasons.

Perhaps we should we recognize that this little piece of flesh is not the soldier himself or herself, that the memory and honor due him or her is due to his or her life and sacrifice, and that the memorial he or she has is not made better or worse by what happens to this tiny bit of rotting tissue. This small bit will return to ash and to dust and has little or nothing to do with the valor and honor due the person who sacrificed his or her life. Sometimes I wonder if focusing so much on that bit of tissue doesn’t actually detract rather than add to the memory of that person and what he or she did as a living, breathing hero.

Frankly, I’m very thankful that I’m on the investigative side of things rather than Mortuary Affairs. No matter what they do, it will, eventually, be wrong.